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0137 GLENEAGLE DRIVE - Health
137 Gleneagle Drive f 1r Centerville � t h i l e�•,# r r � k. A = 191 - 144 J` No. 4210 1/3 ORA Pendaflex' � 10% No. o I Fee THE COMMONWtALLTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppIication for Oisposad �6pstrm Construction permit Application for a Permit to Construct( ) Repair(VlUpgraz e ( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. \'�'� \.Q,,N per,`� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel \ c1\ s Installer's Name Address,and Tel.No. Designer's Name,Address,and Tel.No. to `��fr^K 1-D- Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder/jo Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) � � gpd Design flow provided gpd Plan Date '� ( � \ Z Number of sheets Revision Date Title Size of Septic Tank X( N e!5(L Type of S.A.S. A a d Description of Soil Srep ��CAr- 'Y ,-JCeSN a L4��.►�� e X '3�s' ��� t�<.e, x t p=�cr Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boa Health. Signed - Date Application Approved by Date �— Application Disapproved by Date for the following reasons Permit No. AO "' I Date Issued 5— No. �o ' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS YeS ftpYication for Disposal 6pstPrn. Construction Vermit Application for a Permit to Construct( ) Repair(►Upgrade( ) Abandon( ) El Complete System ❑Individual Components --. Location Address or Lot No. ('3 G\-e. Owner's Name,Add ess,and Tel.No. Assessor's Map/Parcel \ � \ C pM� C�� 'jt� 0 ��`` Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. d ad \� c t_A SJt-c art. C,C,U N-b b a 1 Type of Building: Dwelling No.of Bedrooms ? Lot Size sq.ft. Garbage Grinder/qV 4 Other Type of Building No.of Persons Showers( ) Cafetefia( ) Other Fixtures Design Flow(min.required) ? gpd Design flow provided L( 1 gpd Plan Date .� 1 Number of sheets Revision Date�� y Title Size of Septic Tank e ',c t C,6 Type of S.A.S\ a QC)u-j� ��(e, \A\'(' Description of Soil pS, Q` ": ,���\ R,\C,<-S Z. -b a Nature of Repairs or Alterations(Answer when applicable) ^S � \a _ \ CC, \n� ��rc.�r�rr Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar Health. Signed Date /) Application Approved by Date S— i Application Disapproved by Date for the following reasons Permit No. (7 tU Date Issued 5' ----------------------------------------- ------------.------- - -__- -. _ _ -- ---------------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(L/) Upgraded( ) Abandoned( )by C n�` r�,r_-C at , U� ia�been constructed in accordance with the provisions of Title 5 and the for isposal System Construction Permit No.a01 - f}& dated '5 _ Installer cO sr\ M �r Criv��` Designer _S— C_c{_ 's u G L.P #bedrooms Approved design flow gpd The issuance of this permit shall not be co trued as a guarantee that the system w'dl'function'ode igne . Date t Inspector r No. 690/) — I X)& Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal Opstem Construction Vermit Permission is hereby granted to Construct( ) Repair(V Upgrade( ) Abandon( ) System located at � 3 &\.e r\ G rn u \ c 0 r• A,,, ,' and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. _ 2/ s Date Approved by Town of Barnstable Regulatopy Services BARN szns Thomas Y.Geiler, Director MASS9g, Public Health Division Thomas McKean,Director 200.Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: l a. Sewage Permit# L\ (a(d,ssessor's Ma \Par p cel_ Designer: 'k Installer: EAl4 c.-e +X I. Address: �Z3 _,,Z eA Address: On / ") ( \ was issued.a permit to install a (date) (installer) septic system at �r� a � C%js Wbased on a design drawn by (address S—IE PHf A. 1- p4e- dated S (designer) I certify that the septic system referenced above was.installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. -z r s� � nc A S 'h (Installer's Signature) k�sa _-..A _ (Designer's Signature) (Al=x Designer's'Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTII DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH.THIS FORM AND AS- BUILT-CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.THANK YOU. QASeptic\Designer Certification Form Revised.doc TOWN OF BARNSTABLE LOCATION Qc- SEWAGE# VILLAGE �.yi,�}� ASSESSOR'S MAP&PARCEL Vr ® I 4 L INSTALLER'S NAME&PHONE NO. C�L SEPTIC TANK CAPACITY LEACHING FACILITY: (type) \A c,c o (size) U 2uo; NO.OF BEDROOMS \} -3`70 S- L&n� x �cj��usaf�e OWNER (+ PERMIT DATE: S%"? COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A/A Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within q 300 feet of leaching facility) ,/ �'1 Feet FURNISHED BY t G� C a Town of]Barnstable 36--6 P# DelpartMent table Services • MAft Public Health DivisionL.5-Z951, � i6�9' 200 Maia Street,Hyannis MA 02601 Date Date Scheduled Time---L_ F ee Pd. ©® Soil Suitability Assessment for Sew ' Performed By: 5z� - ge Dzsposal Witnessed By: �' LOCATION:GENERAL INFORMATION Location Address t ^� �~ Owner's Name C� Y`AddressAssessor's Map/Parel: Engineer's Name S"t �i`NEW CONSTRUCTION REPAIRt�s ��` Telephone It Land Use- 9-t-'61 Slopes(gb) Surface Stonesi Distances from: Open Water Body_:-__--___ft Possible Wet Area�ft Drinking Water Well —_____ft Drainage Way ft Property line /6+ �—�ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn Proximity ty to holes) n 0 • V v " Parent material(geologic) d ZJ- 7%-)7"a)+ Depth to Bedrock Depth to(3roundwater. Standing Water in Hole: 6) -- Weeping from Plt Face Estimated Seasonal High Oroundwater /-)/,4 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: .�a-' x�v-,, � Depth Observed standing in obs.hole: Depth to weeping from side of obs._hole: In, Depth to Soil mottles: min _«.__ _ Index Well# - Reading_Date: Index Well level Y In—©roundwgter AdJuetment ft Adj,factor, , ^ Adj.OrpundwaterLrvel, ,a FObservadon / PERCOLATION TEST batr 13 xtme Time at 2"pPero Time at 61' Start Pre-soak Time @ - End Pre-soak Rate MinJlnch Site Suitability Assessment: Site Passed V__11 Site Failed: ` Additional Testing Needed(YM) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the, Barnstable Conservation Division at least one(1) week prior to beginning. Q:I.SEPTICftRCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Surface(in.) Soil Texture Soil Color Soil (USDA) (Munsell) Other Mottling (Structure,Stones;Boulders. 1 0T sWistency %OravPn L-Is --------------- DEEP OBSERVATION HOLE LOG Hole# Z Depth from Soil Horizon Soil Texture Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones,BouldersFen % iJ j LJ L—S V'�.�/l Z� S v L J Depth from DEEP OBSERVATION HOLE LOG Hole# Soil Horizon Soil Texture Soil Color Surface(in.) (USDA) Soil Other (Munsell) Mottling (Structure,Stones,Boulders. i to DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, Flood Insurance Rate Man: h Above 500 year flood boundary No— Yes Within 500 year boundary., No Yes Within 100 year flood boundary No:� Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviogs material exist in all areas observed throughout the area proposed for the soil absorption system? Y4::5 If not,what is the depth of naturally occurring pervious material? Certification I certify that on �l % t_(date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . • the required training,ex tise and experience described in 310 CMR 15.017. Signature Z i Date Q-.%Wl7lWERCFORM.DOC i V03 79- 6o5/ �� � MeUJaU �78'_boy a3 1 ,5,� , 71- 0019ei ors rrn r..-.n.-r�--rr—aer'.—mr•nar+r�r•ren+rt.rr•�r:-.�:+tnr:,'+r'Rnna mnnu rnre.r+vf rrn .. ,• Barnstable TOWN OF BOARD OF HEALTH SUBSURFACE SFHA(;F DISPOSAL SYYSTFM INS CTION FORM - .PART D .- CERTIFICATION -TYPO OR PRINT CLEARLY- PIIOPERTY INSPECTED STREET ADDRESS 137 Glen Eagle Drive Centerville,Mass ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME Anthony Lenci PART D - CERTIFICATION 1 NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. Macomber & S .n Inc COMPANY ADDRESS P.O. Box 66 Centerville Ma 02632 Street Town or CSty State ilP COMPANY TELEPHONE (508 ) 775 - 3338 FAX (508 ) 790 -1578 ,n CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at this address and that the information reported is true , accurate , and omplete as of the time of inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Che krone : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or Lhe environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* \ The inspection which I have con Vcted has found that the system fails to Protect the j)ublic health and the environment in accordance with Title 5 , 310 CMR 15 . 3031 and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date i copy of this ce ification must be provided to the OWNER, the BUYER One Where applicable ) and the DOARD OF 11RALTII. • If the inspection FAILED ,. the owner or " 'Perator shall u d within one year of the date of the inspection , unless allowed orthe requiredm otherwise as provided in 310 CMR 16 . 305 , partd .doc DATE: 10/25/01 PROPERTY ADDRESS: 137 Glen Eagle Drive Centerville, ------------------- Mass. ------------------------ On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1 -1000 gallon, septic tank. 2 . 1 -Distribution box. 3 . 2-1000 gallon precast leaching pits. 6 'X10 ' .Based on my inspection, I certify the following conditions: 4 . This is a title five septic system. ( 78 Code ) 5 . The septic system is in proper working order at the present time. 6 . Pumped the septic tank at time of inspection. Heavy scum & solids layers were present. SIGNATURE: l���Z Name:-J . P .- Macomber Jr_______ Company: Joseph-P . Macomber_& Son , Inc . Address: Box 66 _-Centerville , Ma_-02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY a JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 • COMMONWEALTH OF MA.SSACH-JSET'I'S r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 137 Glen Eagle Drive Centerville,Mass _ Owner's Name:An horsy Lenei Owner's Address: Sam, Date of Inspection: Name of Inspector: (please print) J.P. Macomber Jr. Company Name:Joseph P. Macomber & Son Inc Mailing Address: P.O- Box 66 r,,ntL-rx,il1t: t4a-02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my rraining and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to section 15.340 of Title 5 (310 CMR 15.000). The system: tr'� /Passes _ Conditionally Passes _ Needs Funher Evaluation by the Local Approving Authoriry ails Inspector's Signature�bnnit Date: The system inspector shall a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design now of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Note"s and Comments --This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 37 Glen Eagle Drive Cen ervi e, ass. Owner:Anthony Lenci Date of Inspection: 10 2 5 01 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time System is large enough fora five bedroom B. System Conditionally Passes: 4d One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined" please explain. _ ) The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 'A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: /UU Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced ' obstruction is removed distribution box is leveled or replaced ND explain: ' Ay The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:1 37 Glen Eagle Drive en ervi e, ass. Owner:Anthony Lenci Date of Inspection: 1 0 25 01 C. Further Evaluation is Required by the Board of Health: AID Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. _ System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: /LD Cesspool or privy is within 50.feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safery and environment: At The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. 1 The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. J The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 fee but 50 feet or more front a private water supply yell*'. Method used to determine distance "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:Anthony Lenci 137 Glen Eagle Drive Owner: Centerville,Mass. Date of Inspection: 10/2 5/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or /clogged SAS or cesspool �> Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or / cesspool ,k4�Q,147D's G��l�t _ -iZ Liquid depth in cesspool is less than 6"below invert or available volume is less than %,day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped�,/Jj�t//L'awry Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. _ L Any portion of a cesspool or privy is within 50 feet of a private water supply well. (/ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) kP(Yes/No)The system fails. 1 have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no tthe system is within 400 feet of a surface drinking water supply 4/the system is within 200 feet of a tributary to a surface drinking water supply _Le system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—iWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I I OFFICIAL, INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 137 Glen Eagle. Drive__ Centervi e,Mass . Owner: Anthon Lenci Date of Inspection: 1 0 25 01 Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No _Vumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks ? Has the system received normal flows in,the previous two week period ? /Have large volumes of water been introduced to the system recently or as pan of this inspection ? — Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up ? Was the site inspected for signs of break out? — Were all system components, >icluding the SAS, located on site ? _ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum ? el Was the facility owner(and occupants if different from owner) provided with information on the maintenance of subsurface sewage disposal systems ? proper The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Y, ifi0 � _ Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Pan C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 137 Glen Eagle -Drive - Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 10/2 5/01 FLOW CONDITIONS C.I -2 RESIDENTIAL Number.of bedrooms(design): S_ Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): = Number of current residents: Does residence have a garbage grinder(yes or no): tY Is laundry on a separate sewage system ( es or no): [if yes separate inspection required] Laundry system inspected(yes or no): y Seasonal use: (yes or no): ���J} Water meter readings, if available (last 2 years usage(gpd)): 10 ��44 77i�.G�j C /." Sump pump(yes or no):A;b }� -1 �� r9 Last date of occupancy: 7— COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/person.s/sgft,etc.): Grease trap present(yes or no):d2 Industrial waste holding tank present(yes or no):4e Non-sanitary waste discharged to the Title 5 system(yes or no):,4)h Water meter readings, if available: J9 Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:6—q Q�G7j— Was system pumped as part of the inspection(yes or no): ! If ves, volume pumped: dd,cbgallons-- How was quantity pumped determined? Reason for pumping: gL'y �'��f/!'! ,� ,S;a•�/ s Ad TYPk OF SYSTEM /Septic tank, distribution box, soil absorption system D Single cesspool 0 Overflow cesspool Privy Shared system(yes or no)(if yes, attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank L4,1 Attach a copy of the DEP approval A/� Other(describe): Apr imate agg ofall co ponents ate installed (if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):.�� 6 Page 7 of 1 I OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 37 Glen Eagle Drive -� Centerville,Mass. _. - Owner: Anthony Lenci Date of Inspection: 1 0/25/01 BUILDING SEWER (locate on site plan) Depth below grade: Materials of construction: _cast iron /40 PVC 4/Ather(explain): Distance from private water supply well or suction line: 1Q"� Comments (on condition of joints, venting, evidence of leakage, etc.): �Tni (1t�rl]1Dear + ; r.),t No evidence of leakage The system is vented tr,t-,,,,,,>, - —..�.. t.ie iivuSC vents. ' SEPTIC TANK: locate on site plan) Ides q g1kA_6 Depth below grade: �i� Material of construction: vconcrete•UOmetal fiberglass 4? polyethylene NJother(explain) �/ If rank is meal list age:A�7 Is age certificate) confirmed by a Certificate of Compliance (yes or no);,� (attach a copy of Dimensions: �,6, �D� S�l��l1/?/Q 4"7'� Sludge depth: ' Distance from top of sludge to bonom of outlet tee or baffle: Scum thickness: —scum from top—of scum to top of outlet tee or baffle: d Distance from bonom of scum to bo of -a' How were dimensions determined: o outlet tee or bafflef _7— Comments (on pumping recommendations, inlet and outlet tee or baffle co dition, srmctural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump septic tank eery 2-1 years; T�lpt- R nnt-lAt In tccc arc nl ac�A ThP tank � c etr,,..* i i cn„nri and no evidence of ,e leaka 9 Tank has been mainted every 2-years. GREASE TRAP40pocate on site plan) Depth below grade: ,40 Material of construction:.G�concrete�metal,JfiberglasstLwyolyethylene�ther (explain):_ Ali Dimensions. Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle:, Date of last pumping: A-)4 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): -Grease trap is not DresPnt V 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 37 Glen Eagle Drive Centervr e,Mass. -�- -- - - - Owner: Anthony .Lenci Date of Inspection: 1 0/2 5/01 TIGHT or HOLDING TANKAI+�C-(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: /�A Material of construction: V2 concrete metal WA fiberglass.r A olyethylene^iA other(explain): � Dimensions: Capacity: A,jq"--gallons Design Floe: _ ,/,// gallons/day y' ' Alarm present (yes or no):: Alarm level: W,4 Alarm in working order(yes or no): Date of last pumping: Comments (condition of alarm and float switches, etc.): Tight or holding tanks are not present, . DISTRIBUTION BOX: Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box has one latera.Second pit is piped from the Side of the e tic tank.No evidence or so i s carry over No evidence of leakage into or out of the ox. PUMP CHAM BERVewe,(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments (note condition of pump chamber, condition of pumps-and appurtenances, etc.): Pump chamber is not resen 8 Paae 9 of 1 I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) - Property Address: 137 Glen Eagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 1 0/2 5/01 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required) 2-1000 gallon precast leaching pits packed in 2 ' of 1 -'-," stone. This will handle five bedrooms. If SAS not located explain why: Located. See page 10 Type/ leaching pits, number: Ai' leaching chambers, number. d leaching galleries,number: O leaching trenches,number, length: tiD leaching fields,number, dimensions: :7 /90 overflow cesspool, number: 0 / 4`0 innovative/alternative system Type/name of technology:l/Tij� )7/j- 7FL Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Loamy sand to medium fine sand.No signs of hydraulic failure or ponding-Soils are dry.Vegetation is normal . CESSPOOLS(cesspool must be-pumped as part of inspect ion)(locate on site plan) Number and configuration: O Depth— top of liquid to inlet invert: leo Depth of solids layer: itJ/9 Depth of scum laver: '1#5119 Dimensions of cesspool: Materials of construction: , Indication of groundwater inflow(yes or no): Hl Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspools are not present. PRIVY(locate on site plan) Materials of construction: Dimensions: /9 Depth of solids: Z/;101- Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy is not present, 9 Page 10 of 1 I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION`FORM PART C Itt/st/,� v•,�••,� SYSTEM INVOKMATION (continued) Properry Address: 137 Glen Eagle Drive en t er v i e-, Owner: Anthony enci Date of Inspection: 01 SKETCH OF SEWAGE:DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. a /yd 0,70 '( ,0 (asnoy owt Sou/o) ,tlddns ;IetA )!lgnd 3)�ym 3Ie)o1) '00t U!yIIIA 1II3A Ile W)01 S:()ewy)u;q Jo Si(/ewpuel Sowa�o)at Iu�VW3,1SASh1YSOdSI013:)YM3S110 k)LOS 86/EZ/8 iouaZ AUOT4;UV:'ol,,,ecv, 0 •SS12W'aTTTAaaqua0. aAz.zQ aT529u9TD LE l (p3nv!1V0)i NOILYWMOlNI wns ks D lavd Wb0! N011:)3dSN1 W31StS 1YS0 jV0 30YAM 30YM SOM Page I I of 1 1 OFFICIAL, INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 37 Glen Eagle Drive Centerville,Mass. Owner:Anthony Lenei Date of Inspection: 10/2 5/01 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water�_ feet Please indicate (check) all methods used to determine the high ground water elevation: _Obtained from system design plans on record - if checked, date of design plan reviewed: Observed site (abutting property/observation hole within 150 feet of SAS) _ Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) _ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Gahrety & Miller Model Ground water 1 vat-; nn ahn e qpa 1PvP1 USGS 92- (Q QJ Plata #2 Un.q C)hcarvatino well data Top of Ground Leaching Pit ®�s eet Groundwater: Peet Below Bottom of Pit High Groundwater Adjustment Therefore, the vertical separation distance between the bottom Of the leaching pit and the adjusted groundwater table is r ll TOWN OF B STABLE f LOCATION c SEWAGE # r YII,LAGE ASSESSOR'S MAP & LOT` I Y L INSTALLER'S NAME& PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) � j (size) NO.OF BEDROOMS tea= BUILDER OR OWNER , PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands e ' t within 300 feet o leac 'n cilA ) cp-Feet Furnished r Ld, �. p ozo / y GG PAI A 6Lp DATE: 10/25/01-_-- PROPERTY ADDRESS:-1 37 Glen Eagle_Driv_e___ Centerville, ------------------------ Mass. ------------------------ On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1 -1000 gallon septic tank, f �/ /G 2. 1 -Distribution box. T �e 3 . 2-1000 gallon precast leaching pits. 6 'X10 ' C Based on my inspection, I certify the following conditions: 4 . This is a title five septic system. ( 78 Code ) 5. The septic system is in proper working order at the present time. 6. Pumped the septic tank at time of inspection. Heavy scum & solids layers were present. SIGNATURE:1 _ Name:-J.P. Macomber Jr_______ Company: Josei)h_P. Macomber-& Son , Inc . Address: Box 66 -------------------- Centerville , Ma . 02632-0066 -------------------- Phone:- 508-775-3338 -------------------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY 1 L*N OSEPH Tan MACOMBER c I& SON, INC. ®1 ��\Nod BNO�p�g Town Sewer InstalledPumped &Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 a,c� �--\ COMMONWEALTH OF MASSACHUSETTS : r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 137 Glen Eagle Drive Centerville,Mass_ Owner's Name:Anthony . nri Owner's Address: Sams Date of Inspection: Name of Inspector: (please print) J.P. Macomber Jr. Company Name:Joseph P. Macomber &' Son Inc Mailing Address: P.O. Box Fib r pnt erui 1 1 e Ma 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to ection 15.340 of Title 5(310 CMR 15.000). The system: l� Passes _ Conditionally Passes Needs Further Evaluation by the Local Approving Authoriry _ ails ! Inspector's Signature: i nature�bmit Date: The system inspector shall a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authoriry. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I f Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 137 Glen Eagle Drive Cen ervi e, ass. Owner:Anthony Lenci Date of Inspection: 10 2 5 01 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A: System Passes: 0 have not found anninformation which indicates that any of the failure criteria described in 310 CMR 15.303 or 13tn i u CRK 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the Present time System is large enough for a five bedroom B. System Conditionally Passes: )P One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. _&L The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 'A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: A( b Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: Ad The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:1 37 Glen Eagle Drive en ervi e, ass. Owner:Anthony Lenci Date of Inspection: 0 25 0 C. Further Evaluation is Required by the Board of Health: AJD Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: A) Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health,safety and environment: A16 The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. AZ The system has a septic tank and SAS and the SAS is within 50 feet of a.private water supply well. The Svstem has a septic tank and SAS and the SAS is less than 100 fee but50 feet or more from a private water supply well". Method used to determine distance /f�9lhGli "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other- 3 Page 4 of 1 1 j OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:Anthony Lenci 137 Glen Eagle Drive Owner: Centerville,Mass. Date of Inspection: 1 0/2 5/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No/ �/ ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool -V Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool �ssapeo�A�o�s 6>x l�1 �squid depth in cl is less than 6"below invert or available volume is less than %day flow equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped J--7, ae AVAy Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. �Any portion of a cesspool or privy is within a Zone 1 of a public well. y Portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no tthe system is within 400 feet of a surface drinking water supply _ v the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone I1 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 I r OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 137 Glen Eagle Drive Cen ervi e,Mass. Owner: AnthonyLenci Date of Inspection: 10 25 01 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _ Pumping information was provided by the owner, occupant, or Board of Health Zwere any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period ? �/ Have large volumes of water been introduced to the system recently or as part of this inspection ? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? _ Were all system components, >icluding the SAS, located on site? Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum ? ✓ — Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Ycs o Existing information. For example, a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 137 Glen Eagle Drive Centervill'e,Mass. Owner: Anthony Lenci Date of Inspection: 10/2 5/01 RESIDENTIAL FLOW CONDITIONS G„29T&W46 7 Number of bedrooms(design): 6— Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):✓'Xim Number of current residents:Zi W Does residence have a garbage grinder(yes or no): 1 Is laundry on a separate sewage system (yes or no): [if yes separate inspection required) Laundry system inspected(yes or no): j Seasonal use: (yes or no):.Ae Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no):A�b . �� �. �•� a !. Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): AAA gpd Basis of design flow(seats/person-Is/,�sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):-do Non-sanitary waste discharged to the Title 5 system(yes or no):.40 Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records 1011)� Source of Was system pumped as part of the inspection(yes or no): If yes, volume pumped: dd6gallons--How was qua tity pumped determined?A44 Reason for pumping: y Cj.�/ � ?TYP OF SYSTEM eptic tank,distribution box,soil absorption system Single cesspool WQP Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records, if any) ,jam Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank 4A Attach a copy of the DEP approval Other(describe): A �t^a;p gfall components lat e install (if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): ,60 6 Fage 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Glen Eagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 10/2 5/01 BUILDING SEWER(locate on site plan) it Depth below grade:� Materials of construction: _cast iron _/40 PVC 4/Ather(explain): W,4 Distance from private water supply well or suction line: /d 7' Comments(on condition of joints, venting, evidence of leakage,etc.): No evidence of leaks e.The system is vented ough the ouse vents. SEPTIC TANK: locate on site plan) ldad 440440 -6 ('�! Depth below grade: � Material of construction: !/concrete 4/6metal fiberglass&¢polyethylene NOother(explain) VJ If tank is metal list age:,QQ is age confirmed by a Certificate of Compliance(yes or no) (attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sl dge to bottom of outlet tee or baffle: Scum thickness: _0 a Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bo om of outlet tee or baffle _ How were dimensions determined: Al- 7"—*6 Afe— -V Comments (on pumping recommendations, inlet and outlet tee or baffle co dition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage, etc.): Pump septic tank eery 2-3 yparS Tnlet 9 al,tlet tees are in nl ace_The tank iS st-r„rt>>ra11v sound and ShnugS no evidence of leakage. Tank has been mainted every 2—years. GREASE TRAPA&/ locate on site plan) Depth below grade: to Material of construction:,j&concrete�/ metal, fiberglass polyethylene Wither (explain): Dimensions: AO Scum thickness: 4� Distance from top of scum to top of outlet tee or baffle: A/A_ Distance from bottom of scum to bottom of outlet tee or baffle:_ Z� Date of last pumping: A-M Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease trap is not present 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 137 Glen Eagle Drive Centervi e_,Mass. Owner: Anthony Lenci Date of Inspection: 1 0/2 5/01 TIGHT or HOLDING TANK> &�tank must be pumped at time of inspection)(locate on site plan) Depth below grade: VA Material of constructio concrete dOmetal WA fiberglass d/A polyethylene AL other(explain): Dimensions: Capacity: allons Design Flow: �no): V; allons/day - J' ' Alarm present(y Alarm level: A114 Alarm in working order(yes or no): ('//� Date of last pumping:__Aw_ Comments(condition of alarm and float switches, etc.): Tight or holding tanks are not present, . DISTRIBUTION BOX: Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box has one latera.Second pit is piped from the siap of tic " .No evidence of solids carry over— No evidence of leakage into or out of the ox. PUMP CHAMBER+fowe,(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present. 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 137 Glen Eagle Drive Centerville,-Mass. Owner: Anthony Lenci Date of Inspection: 10/2 5/01 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) 2-1000 _gallon precast leaching pits packed in 2 ' of 11" stone. This will handle five bedrooms. If SAS not located explain why: Located. See page 10 Type // leaching pits, number: Neleaching chambers,number: (� V,9 leaching galleries,number: O V!) leaching trenches,number, length: D A-70 leaching fields,number, dimensions: O ,00 overflow cesspool,number: 0 � ,� /' /� 1J0 innovative/alternative system Type/name of technology:7/- �/A� /`lP C� z�L Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): Loamy sand to medium fine sand.No signs of hydraulic failure or ponding-Soils are dry.Veaetation is normal CESSPOOLS(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: O Depth—top of liquid to inlet invert: Depth of solids layer: AO Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspools are not present. PRIVY444/ (locate on site plan) Materials of construction: y/9 Dimensions: Depth of solids: .4/ Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy is not present- 9 SUBSURFACE SEWAGE DA�OSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION fcontinutd) Ptopiny Addicts: 137 Gleneagle Drive 'Centerville,Mass. °""c" Anthonyenci o,ic or inspection: Y 8/23/98 SKETCH Of SEWAGE DISPOSAL SYSTEM: inctvdc ties to at least two permanent references landmarks or benchmarks IoCaie all wells within 100' (loutc where public water supply comes Into house) nor,; r o 040 � G4P,t/ -P �1 4Lp 8utpltnq ayI siawa,Ciddns aasem otlgnd aiayM olsoo-T •1223 001 utyltM SllaM lle 21e00^1 'S,XeUryauaq Jo sNivurpiml aoualajal Iuousuvad oMI Iseal It,o1 sap Butpnlout wass,(s lesodstp aBeMas'iyI)o yala,{s a aptno.d W31SAS'1VS0dSIQ:39YM3S d0 HD13NS L 0/S 7/0 L :uotpadsul p a)eQ iauarr AUOL[quv ,jaaMO •sst?id aTTTAialuan aATJG aTBPS uaTD L£ L :ssajppY ,(wadoj(f (panutluoo)NOI.L` VjgpW wa LSAS O luvd wuw AIOI.LJacmi wa LSAS lvsoclSIQ 30vmas aDva- asaf1S S. N3WSS3SSd A2id.LAIf1'IOA HOA ION-MOA NouDaasm Tvioi3,I0 �' I I!o 0l aSed Pjge I 1 of 1 I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Glen Eagle Drive Centerville,Mass. Owner:Anthony Lenci Date of Inspection: 10 25 01 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate (check) all methods used to determine the high ground water elevation: _Obtained from system design plans on record - If checked,date of design plan reviewed: _Observed site(abutting property/observation hole within 150 feet of SAS) _Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Gahrety & Miller Model. Ground water elevation ahnvP sea lPvPl _ USGS 92-0001 Plate #2 lung nhGerxratinr3 well data Top of Ground Leaching c Pit 'eet Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment Therefore, the vertical separation distance between the bottom Of the lea0l]29,pit and the adjusted groundwater table is feet. / X� it •nRrS Tr�ntTTT— rnrnr'r+m'ts-�r.r renmlr rl++ttfrrr�r.Tt'nm TRM1'Y fllw7ntYtwT • �I TOWN OF Barnstable BOARD OF HEALTH SUDSHFACE SEWACF DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION :0•••tf•1�T•'.••.'t—T.t1I.�.�1T1.TT.1w'It.•RI TIIRlrSTtftT�'T'�'7rItRR't il'RI�"P'nll�r/R1wl.�IA TIIf ..--trrrr-�. —. -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 137 Glen Eagle Drive Centerville,Mass ' ASSESSORS MAP , BLOCK ANll PARCEL # OWNER' s NAME Anthony Lenci PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. Macomber & San Inc COMPANY ADDRESS P.O. Box 66 Centerville Ma 02632 . Street Town or C1ty State LIP COMPANY TELEPHONE (508 ) 775 - 3338 FAX (508 ) 790 -1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that t)le information reported is true , accurate , and omplete as of the time of .inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , ' ii i Iltir. I. Ch kk one ., !w g ystem PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15r303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form, System FAILED* The inspection whic)I I • have con acted has found that the system fails to Protect the i)ublic health and the environment in accordance with Title 5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature ZllejEea�_ Date .xzsr _,a.�,� copy of this ce ification must be provided to the OWNER, the BUYER One, whre applicable ) and the BOARD OF HEAL'I'1l, * If the Inspection FAILED, the owner or"'oparator shall upgrade ' the aystem within one ,year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 15 . 305 . partd .doc 1 LbCA.TION SEWAGE PERMIT NO. . /32LFti �GLr' v2 VILLAGE le INSTA LLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED 9— 7- 21 DATE COMPLIANCE ISSUED // -. -Zs - 29 Y;7 e • I DATE: . PROPERTY ADDRESS: 1:37 Gleneagl•e Drive Centerville,Mass. 62632 , On the above date, I Inspected the s-eptic system at the above address. This system consists of the following: 1 . 1 -1 000. gallon septic tank. 2 . 1 -Distribution box. 3 . 2-1000' gallon precast leaching pits. Based bn my Ineo&ctlon, I certify the following conditions: 4 . This is a title five septic system...,,( _38 'Code . Y 5 . The septic system is in proper .working order at the present time. 6 . One .pit is dry the newest pit has waste water that is 54" below the invert pipe. SIGNATURE: Flame: J . P.Kacomber Jr., -------r--------------- `. P_Macomber &- Son•_Inc Company:_ Address:_-Bic-6b------- -- -- __CentervilLe , Mass__02.632 ` Phone:___508.17 .3338---_--- . 1 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY • JOSEPH P. MACOMBER & SON, INC. Tan k&-CeupooIPLeachflelds Pump+d 4 lnst4lled Town Sewer Connections P.O. Box 66' Centerville, MA 02632-0066 77-5-333-8 775-6412 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292.5500 WILLIAM F.WELD TRUDY CO Govcmor _ Sccrct ARGEO PAUL CELLUCCI DAVID B.STRU Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR mmissio PART A CERTIFICATION Aj6fA78f4)?N Property Address: 137 Gleneagle Drive CentervillRddress of Owner:Dateof Inspection: 8/23/98 Mass.(If different)Name of Inspector: h_P Mar-=ber Jr.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 1'S.00Q) Company Name: J.P.Macomber & Son Inc.Mailing Address: BOX 66 Centerville,Mass. 02632Telephone Number: Sp8-71�_3338 CERTIFICATION STATEMENT I certify that I have personally ins -?tied the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of in,;,eciion. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: asses Condition;:lly Passes Needs Fur-.her Evaluation By the Local Approving Authority Fails OKInspector's Signatur e: Date: —/?l—� The System Inspector all submit a copy of this inspection report to the Approving Authority within thirty(30) days of completing this inspection. If the system is a sh,.r:d system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regicr.al office of the Department of Environmental Protection. The original should be sent to the system owne and copies sent to the buyer, if ;,;:,cable, and the approving authority. INSPECTION SUMMARY: Cl-.ec:; A, B, C, or D: A) SYSTEM PASSES: I have not found any ir ..r:,•.ation which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not ::,..;.rted are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY I':•.SScS: 4121 _ One or more system cc,,,;:, ,ents as described in the "Conditional Pass" section need to be replaced or repaired. The system, upor completion of the repla::-_ :,,_nt or repair, as approved by the Board of Health, will pass. Indicate yes,no, or not determin ;! (Y, N, or ND). Describe basis of determination in all instances. If"not determined', explain why not. �J The septic tar,:; i metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of �. Compliance (:.-_:i),�d) indicating that the tank was installed within twenty(20) years prior to the date of the inspection;,o the septic tan;., ..;,ether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imm::: .,t. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved h; c Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:/hvww.ma gnat.atate.ma.0 side p Printed on Recyded Paper r LQ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 137 Gleneagle Drive Centerville,Mass . Owner: Anthony Lenci Date of Inspection: 8/23/98 8) SYSTEM CONDITIONALLY PASSES (continued) Jaye Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box Is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to pr(cea ih public health, safery and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: ,/0 Cesspool or privy is within 50 feet of a surface water JQ Cesspool or privy is within SO feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THA THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply o tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates the the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to o less than S ppm. Method used to determine distance ._(approximation not valid). 3) OTHER (revised 04/1S/17) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 137 Glen Wagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 8/2 3/9 8 D) SYSTEM FAILS: You must indicate eiv,er 'Yes' or"No' as to each of the following: (Ah_ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No/ backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. I Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or / cesspool. v Static liquid level in the dA A stribution box above outlet invert due to an overloaded or clogged SS or cesspool. c�" j� Liquid depth in cevpdcJ-is�less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT,due to clogged or obstructed pipe(s). / Number of limes pumped a. l� Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. A portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or"No' as to each of the following:• The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design now of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No: j IA the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is'located in a nitrogen sensitive area (Interim Wellhead Protection Area• IWPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please.consult the local regional office of the Department for further information. tr•vl••d 04/2S/W D•fl• 3 of 10 .SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 137 Glen Eagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 8/2 3/9 8 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No, Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ Z As built plans have been obtained and examined. Note if they are not available with N/A. Z _ The facility or dwelling was inspected for signs of sewage back-up. _ Z The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components,LRcllucling the Soil Absorption System, have been located on the site. 4/ _ The septic tank manholes were uncovered, opened;and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. — The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. Z _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)) (revised 04/25/37) D.Q• 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 137 Glen Eagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 8/2 3/9 8 FLOW CONDITIONS RESIDENTIAL: Design flow: L1p. /bedroom for S.A.S. Number of bedrooms: Number of current residents:_ Garbage grinder (yes or no):A& Laundry connected to system (yes or no):V.- ! �r�oo0 Seasonal use (yes or no):� 99� �// U J �} Water meter readings, if available (last two (2) year usage (gpd): 1997:: "[i/i d C.CO�/(ln� G.�1� q7S. Sump Pump (yes or no):A Last date of occupancy: COMMERCIAUINDUSTRIAL: Type of establishment:_ x_10 Design flow: .M gallons/day Grease trap present: (yes or no)?/h Industrial Waste Holding Tank present: (yes or no) !L'4 Non-sanitary waste discharged to the Title S system: (yes or no)�i� Water meter readings, if available: IM Last date of occupancy:—J&— OTHER: (Describe) A)4 Last date of occupancy: Al GENERAL INFORMATION PUMPING RECORDS and source of information: 3 :' PGc�- .�19 System pumped as part of inspection: (yes or o)2,0 If yes, volume pumped: Q�Ballons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool �t!) Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) VA Technology etc. Copy of up to date contractl Chher APPROXIMATE AGE of all components, date installed (if known) and sours f information: d� Sewage odors detected when arriving at the site: (yes or no) (revised 04/]5/97) page 5 of 10 C ustomer Data E ntry S tree n 8124198 Name: Anthony Lend Cusbam er Address: 137 Gleneagle Drive alen code: Town: Centerville State:MA zip:02632 tl Ming addrem: 137 Gleneagle Dr CenteryiIle MA 02632 Tel 771-4063 Te12 Notes: Pump every June call first rec: 1998 619194 pump T 135.00 2 tees 50.00 6124194 3130196 pump T 145.00 415196 613198 pump T 145.00 6112198 SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:137 Glen Eagle Drive Centerville,Mass . Owner: Anthony Lenci Date of Inspection: 8/2 3/9 8 BUILDING SEWER: (Locate on site plan) Depth below grade: rf Material of o struction: -4 cast iron 40 P C of r (explain) -CI4' Distance from private wat r supply well or suction line_�_ Diameter 41 Comments: (condition of joints, venting, evidence of leakage, etc.) Joints appear tight No Pyi denne of leakage; System is vented thrnttgh t-he hn„ag tTQQ+- - SEPTIC TANK:,rM (locate on site plan) N Depth below grade:- Material of construction: concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age&I Is age confirmed by Cenificate of Compliance (Yes/No) Dimensions: o %S/r Sludge depth: � Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baHle:Z,�-- Distance from bottom of scum to bottom f outlet tee gr baHle:,1z,&e-k, How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.)PUMP tank every 2=3 yPay; Tn1 Pt P, niitl At tees are in place•Liquid level at the n„t 1 et i n-uzart Jr. fifty one i nnhes;The tank is strily-telly squRd &i3d--9ha GREASE TRAP:, e (locate-on site plan) Depth below grade: Material of con structionA concrete4/ metaWXFibergIass409 Polyethylene,&dother(explain) AIA Dimensions: 1W , ' Scum thickness: Distance from top of scum to top of outlet tee or baffler Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: _AkL4- Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,-etc.) :ease trap is not present (revised 04/25/17) P&y• 6 of 10 . V SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Gleneagle Drive Centerville,Mass . Owner: Anthony Lenci Date of Inspection: 8/23/98 TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade:,04 Material of construct ion:,VAconcrete 44metalp Fiberglass,c&Polyethylene /Zother(explain) VA Dimensions: AM Capacity: A)A gallons Design now: gallons/day Alarm level: Alarm in working order AA Yes:l No Date of previous pumping:A)A Comments: (condition of inlet tee, condition of alarm and float switches, etc.) Tight or holding tanks are not present DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert:��_ Comments: (note if level and distribution is equal, evidence Qf solids carryover evidencg f leakage int or,out of box, etc.) Distribution box has two �aterals— evidence or solids carry over. Nn pvidenr•p of 1pakage into or nut of the distribution box. PUMP CHAMBER:It? (locate on site plan) Pumps in working order: (Yes or No)wv Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appunenances, etc.) Pump c am er is not present. (r•v1&.d 01/JS/f7I Y•9. 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 137 Glen Eagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 8/2 3/9 8 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:Q leaching galleries, number: leaching trenches, number,length:�-- leaching fields, number, dime lions: 0 overflow cesspool, number: Alternative system: Name of Technology: . Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Loamy sand to medium coarse sand No signs of hydranl ; r faililre or ponding•All vegetation iG normal CESSPOOLS: (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: A Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as pan of inspection) Cesspools are not present - Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Cesspools are not 1)resPnt -- PRIVY:11/2/Q (locate on site plan) Materials of construction: Dimensions: Depth of solids:_AW Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Privy is not present - (revised 01/1S/97) Pay• 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propenr Address: 137 Gleneagle Drive 'Centerville,Mass. oats of Anthonyenci O�te of Inspection: Y 8/23/98 SKETCH OF SEWAGE DISPOSAL SYSTEM: inclvde tics to at least two permanent references landmarks or benchmarks locate all wells within 100' (locate where public water supply comes into house) -27 �, 3 s9 . o Ozo GGPA/ -oA 6LP WIWI,) /.y• j of 10 SUBSURFACE SEWAGE DISPC;: ,t. SYSTEM INSPECTION FORM P:,i'T C SYSTEM INFOR'.t .PION (continued) Property Address: 137 Gleneagle Drive Centerville,Mass. Owner: Anthony Lenci Date of Inspection: 8/23/98 Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record bservation of Site (Hbunin roperry bservation hole, basemen sump etc.) _ZDetermine it from local conditions Check with local Board of health Check FEMA Maps —Zcheck pumping records (/ Check local excavators, installers Use USGS Data Describe in your own words how you established the High Grounc}.vrertElevation. Must be completed) Used water contours map. Gahrety & Miller Model 12/16/94 (revisal 04/25/17) P&p.- ']Q0f 10 t>•...n,n.-n.•r�.-.7'r.n.-arw v.rw.rl.n 11.rr►'#n1R Tar.trr+.wT rntr+lY rs1.•r�1 win I 'I'OWN OF Barnstable BOARD OF HEALTH I ,SUBSURFACE SEWAGE D131`03AL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION ��•Tf1�T'•.'t:,-1,1I.t�.,{1TTRA Y1.11,TRIInf.Y."InTrr•\l '..nR .IRAI-T'A�I Nt.-..t�t�nT\ TAnY1R1r1Tf1r•P'T�>•T.;r+�T'.+1r -TYPO OR PAINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 137 Gleneagle Drive Centerville,Mass . ASSESSORS MAP , BLOCK AND PARCEL OWNER' s NAME Anthony Lehci PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & ScIf "Inc. COMPANY ADDRESS Box 66 Centerville,Mass . 02632 . street Tom or City state LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 1 790 - 1578 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system a this address and that the information reported is true , accurate , and complete as of the time of ,inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on site sewage disposal systems . Check ne : Systeui PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public healUi or ,t-he environment as defined in 310 CMR 16 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . Sys terp FAILED* The inspection.. wllicll I have con cted has found that the system fails tc Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this Inspection form . Inspector Signature - Date One copy of this certification must be provided to the OWNER , the BUYER ( where applicable ) and the 130ARD OJ?' IIEAL7'JI. • If the inspection FAILED, the owner or oporator shall upgrado ' tho ayatem within o'ne year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 16 . 306 . partd .doc C W f'7 ti - ss byv 3f ol� THE COMMONWEALTH OF MA.SSA.CHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE S SYSTEM INSPECTOR as provided in 310 CMR 15 .340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. Actisy. D.rcctor of the l) i lull ul w.ttct Pullutiun Control L —1- No..../..a:-�J f�... Fxs....�3 0:.0 0 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrurtion 11trutit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 137 Glen Eagle Road Centerville, MA ................_................................................................................ ..-----•----•------------..._......•----......------•-----------............-----................. Location-Address or Lot No. Anthony Lenci Same •---------•-----------.......................•---........---------•----•-----------........._.... --•---....-•••--.....----.......---•-------------...••-----------•••-••----•------..............-- W W. E. Robinson 9eprtic Service P.O. Box 1089, A 'enterville, MA Installer Address Type of Building Size Lot•.__------•-----------------Sq. feet Dwelling—No. of Bedrooms.........3................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures .----•---------••----•-•--•-•-------------•----•-------•--------•-......-------•--•---.........-•---------•-••---------.......-•---•------....-----•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ ,.� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-------------_.......... fZq Test Pit No. 2................minutes per inch Depth of.Test Pit---z................ Depth to ground water........................ a ----•----•-•-----------------------•-----------•--------••----------••-••-------•----•------------•-......................................................... 0 Description of Soil......... ravel -----------•....................................... W W U Nature of Repairs or Alterations—Answer when applicable_--__- 9�k l l on---p r e c a s.t..__.stone.-.......... Lacked -leach...pit --------------------------------------•---------...._..._......._.......---•------•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental CodeyL The unVsigged further agrees not to place the system in operation until a Certificate of Compliance has b issu a and of health. Signed ... --- ....... ...""--...'--......-"---'--". .... .................. ........ Dace Application Approved By ........... .e w,� -��v--►+.--�.�� f ..::...j..�{.;.- J� UU Dare Application Disapproved for the following reasons- -----------------------------------------------------------------------------------.................................................... ......................... ........................'---...........---"---'- --- ......--"----"'-" -- . . --------------------------------...... ........................................ PermitNo. ------.1-- --- � . .--- 1 ..............--"---- Issued ---'----"--"--"------------'---------"----"----.-Da e...... Dace 130.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE Applirttiiun for Disposal Works Tonstrurtion jJerumi# Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 137 Glen Eagke Road Centerville, MA I,,pcation-Address or Lot No. Anthony LenC, Same W W. E. Robinson S Ftic Service P.O. Box 1089,-A Center_ville, _MA Installer Address Type of Building Size Lot-- ------------------Sq. feet �-, Dwelling—No. of Bedrooms.......... ______________________•_-_______Expansion Attic ( ) Garbage Grinder ( ) a 04 Other—Type of Building ___•____________________•••. No. of persons-•_____-_-_______.-.__`__._ Showers ( ) — Cafeteria ( ) QOther fixtures -- ----------------------------------------------------------------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width---------------- Diameter----------------Depth______•.__-.__•. x Disposal Trench—No--------------------- Width-------------------- Total Length--------------------Total leaching area_-------------__.sq. ft. Seepage Pit No-----------_------- Diameter.................... Depth below inlet-------------------- Total leaching area------------------sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date-------------------------------------- Test Pit No. 1----------------minutes per inch Depth of Test Pit------------------- Depth to ground water__-______________-_____. (_, Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water__________________•_____ P4 ---------------------------------------------------------------------------------------__ - - —--------------- -_ -- ODescription of Soil-------G r a v-_e 1------------------------------------------------------------------------------------------------------ U ------------------------------------------- ----------- ---------------------------------- --------------------------------------------------------------------------- -------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- W UNature of Repairs or Alterations—Answer when applicable------1 -000__Ma1 1 Qn__pre.r-aa-ct nne.=-_-----_-_ Aac--ec----leach---p i_t ----------------------------------------------------- - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Codez The and-sign d further agrees not to place the system in operation until a Certificate of Compliance has?�e Issu y he - • rd of health. / Signed ---------------------------✓---------------------- - �- -!. ApplicationApproved By -----------C - %! ------------------------------------------------------------------------- ---- - -=-Di� Dire Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- Permit '�: - Issued »ate ------------------------------ No ---- -- F THE COMMONWEALTH OF MASSACHUSETTS �. BOARD OF HEALTH TOWN OF BARNSTABLE (ger#tftra e of 01 myCtttnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired'( X ) by--------W-'E------Robinson__Septic---S e r v i.c e ---C e n t e.r v i11-Q-`----MA---------------------------------------------------------------------------- hmaller at ---------137 Glen Eagke Road_,_ Centerville, MA ------ --------- ------- ---------- -------- --------------- ------------------------- ------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -------- 7.-.._5-1_P----------- dated ______..____---_.-_______._______-----_-_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE----------------------- -�L ^�� . "1- -------------------------- Inspector --------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.-91_' �. .... TOWN OF BARNSTABLE FgE-$30_00 Disposal sal larks Tuns#rudinrn f erumtt Permission is hereby granted.....E. Robinson -Septic Service _______••---_--___- to Construct ( ) or Repair LX ) an Individual Sewage Disposal System at No.137ten Eagle oad, Centerville, hi Street as shown on the application for Disposal Works Construction Permit No.,5�'� `I __ Dated------------------------------------------ -------------------------------- —------------------------------------------------- October 15, 1992 Board of Health DATE --------------- --- !\\ s FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS V N .................... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF........ .......................... Appliration for Dispoiial Works T=31rurtion thrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: .... : -�N I.E........Z:>.O.!......... .................Zvri2tl..........1-3................................................. 24� eafi, L cation w-e Add or Lot No. SS ddres s ........... ........ ............................... .................................................................................................. Address Installer r Type of Building Size Lot. ...Sq. feet Dwelling—No. of Bedrooms.___.___.._ IP....... (No ................Expansion Attic Garbage Grinder Qv6 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria 04 Other fixtures ........................................................ C� ---*----------------------------------------------------*--------------------------------- Design Flow...........ZZ.4 0....................gallons pe erlay. Total daily flow........ 0.................gallons. Liquid' Width. Diameter................ Depth-.6--9..- / Septic Tank r! 1:4 Length I.. .... Disposal Trench—No_..................... Width___®.__-_.____.__. Total Length_._.._______....._._ Total leachingarea....................sq. ft. Oe ' - -, 'Z IC?..sq. ft. Seepage Pit No......./.......... Diameter________._..__ Depth below 1*t.e Total leaching area.0 -45. Z Other Distribution box (A."T DosiMtank 6P 7 0/ ''- -7--4t, , 0-4 Percblation Test Results Performed 6--.64150��KZ>..R'S', Date...X.e.�-PrL.-y AV->.)r. 1-4 1.4 Test Pit No. 1-G Z....minutes per inch Depth of Test Pit..�......... Depth to ground water-ok.'0AI.e.---- Test Pit No. 2..4Z---minutes per inch Depth of Test Pit_/.'............ Depth to ground water.-Ajo-ruc ............................................................................................................................................................. 0 Description of Soil----.0-. -.C-OAlq.......Aeil:>........5a.27S.,0.1.4 ........................................................ ---------------------- .........ZV. .......4�4.,Xems - ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLILT= 5 of the State Sanitary Code—Th�undersigned further agrees *not to place the system in operation until a Certificate of Compliance has been issued by the board of health. .,7Signed ................ ........................................... ............Da.t.e............. ------------------------............... Application Approved By............7/ ------------------------ Date Application Disapproved for the following reasons:............j.....................................................................-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.- .-.-.-.-.-.- ........ ............ .... .............................................................................. ....................... .............................................................. Date-Permit No...........------ t_ hIssued...I -A...-- ---r Date No.---............ .. Fss..t.l ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TO.(AJ \3.............OF....... .1 ............................. Applirattiun for Disposal Works Toustrttrtion Prrmit Application is hereby made for a Permit to Construct (+ ) or Repair (` ,) an Individual Sewage Disposal System at: ; .. C.G% 1:. :�.. ........ f'=----•--- ez.V. ............4 .1......./...................................................... �tI Ilocation-A or Lot No. .............•........•.... .... W Owne Address ,.a ........ e.5----------------------------------- ------------------------- Installer Address ,� UType of Building Size Lot.r_62._✓• .!5....Sq. feet .� Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Qvo) Other—Type T e of Building No. of persons............................ Showers Gr YP g -------------•-•--...---.... p ( )--- Cafeteria ( ) WDesign Flow.Othe��40es.................gallons pe>�on p r day. Total daily flow__.-_- ..................gallons. WSeptic Tank—Liquid capacity/.Agallons Lengthe..�' .. Width_��__��_..... Diameter................ Depth.�..�_.... x Disposal Trench—No..................... Width._......._..._.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......�.......... Diameter._! ............ Depth below Injet.�"_.'�. __. Tot 1 1 ching area_ a ._sq. ft. Z Other Distribution box Dosing tank ( ) ti� ,�"G ' 7 of a Percolation Test Results Performed byX's0t!t..a,!1c._.;P......4. ._._ !,.4;:��)-_P...,JA Date...'^'ePl": .... �.���� F.a Test Pit No. 1_z'-_.�.....minutes per inch Depth of Test Pit-.I�........... Depth to ground water.,A.41-'_:°....___. 44 Test Pit No. 2._�Z_.._minutes per inch Depth of Test Pit,".............. Depth to ground water.4;,1.o_.tIA.41._... a ----•-•---------------------------------•------•--....... :... ....... .---.....-------------------------- D Description of Soil..... �" ..`l..� es �i�.t4... .�d:l�-- --SOA.r�t�l ------•-•........••..•--........................................................ -------------------------- UNature.of Repairs or Alterations—Answer when applicable.............................................:.................................................. ...----•...---•------------------------•--------....----.............-•-------------........----•------•---.....------------------.......--------------•---------------------------......---•---•.--•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT i.j'i. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. >gned Date Application Approved By----- ' G ---------- Date Application Disapproved for the following reasons:-----•----------------------------------------------------------------------................................. ......--•................•-•--....---•--..........---------------•---••----------•------•-----.......------..........---------•----•-•-•---•---•----------------------------------------•-------•-•-•--- Date PermitNo.................................. Issued.................... Date............................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . !.................OF........i , ! 1 ? '. '........................ Trr#if iratr of TonapliFanrr T S TO ERT F hat the Individual Sewage Disposal System constructed or Repaired by ( ) -------------•--••-•---•---..........._....._.._...-- .....- � lF,�• -- _ Installer has been installed in accordance with the provisions of T 1 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_ . ._- ..,0_.; ........•... dated__..Or -''►I, �-- '_J4.................... THE ISSUANCE OF THIS CERTIFICATE SHAL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................••-------...-•---•-----.......---••-•-----....------..... Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '� .,+!V............O F....... i''S' C ./... .r, i . ...........:. _...y..... ` FEE.r K•. ... 1 Disposal Nods T-Fonuirurtion rrutit ' Permission is hereby granted.............................................................................................................................................. to Construct (�)mor Repair ( ) an Individual Sewage Disposal System _ at No....�'1 1...--•---/`.: ....---•-- ........ . ------ ---C .... tit! L�° .................. Street n as shown on the application for Disposal Works Construction Pe ' No... _._. ated... .= i `_'.:../... ............ ----•--- - .................... oard of ealth DATE................................................................................ JJ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �.. TOWN OF BARNSTABLE i LOCATION /:3 4=b SEWAGE #��` VILLAGE 11 I ASSESSOR'S MAP & LOT / f INSTALLER'S NAME & PHONE NO. �0 '�gEPTIC TANK CAPACITY IU 6 LEACHING FACILITY:(type) 16 6 0 4,4 k' 1 (size) 4� `� z NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER C 1 DATE PERMIT ISSUED: /o —/c9— 1$,?-- DATE COMPLIANCE ISSUED: 16—,;L 6"�,� VARIANCE GRANTED: Yes No I p /� !L ti [ S 4 -+�` ' � i �� e ilk LOT /4 ; TEST HOLE � asp �M1 Et CV, SEPT, 5 , /979 /5 7. 56 •, PAUL NIURKAY - INSPECTOR CID W { D- d,4 LOAM, A I� 'D c 'co i 5UC35Ol�. YI a4 144 LAYER CQARSE ul L1-r, L t t . o n o W y 5,gND AND GRAJ/.L Lli Q c ��. � E C E LE V. s c L4 cc ,co LJ /GO . 33 LOT l.a: N (� 30 FT'O/V7- ZD S/E3E / 2 TZ�4T� F'2 0,ao.SF.17 SEPTIC 5y5TEM CONST2UCT1.0AJ SHALL COnlFa2M TO i✓/ASS • OES/GAJ FL W 3� GALS,D,4Y• E/V V/e O/vMG--n/T;4 L CODE- T 1 7"L� , ,'7'/ 7 L3 fZ7`�1 I LL-.,4 C.�/ VCN 0p0S�L� L�.�--...Ltd ,LEq(J/,eCD LE�C:y 1,2E TO?�. ,�1 L T.y TZ L1L A 7`i O n/5 of 02Ovo5G r� EaCN A✓}>�.4 M;an/N a�E � 0 VE,P— TO �X.TEn/D Tp !t'✓pE t2 V/OUS O t/E.� M T/-///V i' T� p2E-✓Eti/T /�/ES � /U / Z¢ LorlT25 /o" � D/5T.. 30X i" Z/"N/iDE Oi/E.2" 4 CASs AA.ill / T % M/n/ �i rc fi ,., / D/A. -y- Mntl [� %4"I FOOT I .1D D D. _x _ /NY T <f C' TON 1 _ / GA L-L O N/ /,v vE 2 T VEeT �L1/�ITG1dT/GNT) /NVEQT NO GA25ACE G,21AJD�2 sJ SEPT/.- rAA./K, L7/57-1Z/BUT/ON 80X R 1 �SG CSOULW T��TS� A/�/D L�ACf//�l/G F�/T orrA,: Q TO /3E OF E/n/F�-�r�CE� co��c,I ARTH'UR GfFFt3R[) N CQNG'2ET� 5 T2ENv:'�/ 3000 ;/ Al. nn /� �� �. �'' ND. F RANK-- t-4 A '. 's i ' '�C/S1F�`�� TAR ,�f_ /O LO,Q D//vim 4,01 �t.... •1 ' H �. LP,2/` `E VvW,' NUT TO BE L0,,4A7 t��? Z G E RT/r Y T#� ! G LSi+ or p '-' �/GA-/ 0,'l EVA-1 / 'TH/5 P4.A N' iS PRC)poss'b orq T-•4 dEO G¢ , G RDUND AS �5-kIDWN �A N tD . 0" D'oc-s-l c, #' L.v I T W� - 7 N !3U%Lf.� INCr, � Tl3AC f F R6allIREMENT5 '+ . - Q.iC' 13R.R•N S Ts4*2 h/E4.LT�-/ .,4�E�vT '- �,�. A ++. _ y. ,W`, _s . 9" MINIMUM. ACCESS COVERS MUST BE WITHIN INSPECTION 6 MAXIMUM COVER INVERT ELEVATIONS : DESIGN CR I TER I A : GENERAL NO TES : 6" OF FINISH GRADE PORT a"VENT OR INVERT OUT SEPTIC TANK: 96.5 DESIGN FLOW: FIRST 2• TO �� CHARCOAL F 1 L TER BE LEVEL /8" MIN INVERT 1N DIST. BOX: 97.85 3 BEDROOMS AT //0 G.P.D. PER 1. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION ros.4 102.5 INVERT OUT DIST. BOX: 97.68 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY. 4' DIAM PIPE INVERT IN LEACH CHAMBER: 97.62 CLEAN SAND BAGKFILL NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS 98 5 7 6 11 " H-20 AROUND AND 2" OVER CHAMBERS BOTTOM OF LEACH CHAMBER: 96.7 SET. SEE SITE PLAN. cas 7 � � 6 96.7 ADJUSTED GROUND WATER: N/A CELLAR FLOOR - 100.0 BAFFLE SEPTIC TANK REQUIRED: 12 HIGH CAPACITY INFITRATOR OBSERVED GROUND WATER: N/A - 660 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND 3 OUTLET 330 G.P.D. X 20O EXISTING CHAMBERS /N TRENCH FORMATION BOTTOM OF TEST HOLE #I: 9/.5 D-BOX MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1000 GAL SEPTIC TANK PROVIDED: 1000 GAL. EXISTING SEPTIC TANK H-20 °°''L �� i ,`� � CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL 6" CRUSHED STONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. COMPACTED BASE DESIGN PERC RATE C 5 MIN/INCH SOIL TEXTURAL CLASS - l 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER P R O F- i L E : NOT TO SCALE EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFF 1 C OR GREATER 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF Wl TH- N STANDING H-20 WHEEL LOADS. PROVIDED: I2 HIGH CAPACITY INFILTRATOR CHAMBERS. 12 x 6.25'x 7.79 SF/FT - 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC:,OR 584 S.F. x 0.74 - 432 GPD APPROVED EQUAL. 6. SEPTIC TANK AND D-BOX SHALL BE RE 1 NFORCED SOIL TEST PIT DA TA s PRECAST CONCRETE OR APPROVED POL YETHYLENE'. INDICATES V INDICATES BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE`WATER ` - PERCOLATION OBSERVED TESTED FOR LEVEL WHEN THERE lS MORE THAN ONE Io3.4 TEST - GROUNDWATER OUTLET. �// veN SrocKAVEFF 28 20.E / TP #1 P#13306 TP #2 7 TP/I S� 57 BEFORE CONSTRUCTION CALL D 1 G- SAFE". i ..;;. :._ TPs2 1-888-DIG-SAFE AND THE LOCAL WATER DEPT. / 6` CHERRY _ 102.3 HORIZON TEXTURE COLOR HORIZON TEXTURE COLOR i s' OAK :. 0" !02.5 0" 102.5 LOAMY IOYR LOAMY IOYR FOR LOCATION OF UNDERGROUND UTILITIES. o-Box A SAND 2/2 A SAND 2/2 p ' 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE h a l LOAMY IOYR DES 1 GN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION h 102.9 p LOAMY IOYR o' t� 12Hf6HCAPACITY I L� SAND 4/6 OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE c, SAND 4/6 p ? INFIL TRATOR CHAMBERS �.. t\ Ia2.9 30" - - - - - - - - 100.0 28" - - - - - - - - - - - - - - - - - - - - 100.2 CONSTRUCTION INSPECTIONS• MED-COARSE IOYR C MED-COARSE IOYR BM-CDR CONC� / SAND AND 6/6 SAND AND 6/6 9. EXISTING LEACH PITS TO BE PUMPED DRY AND `I C' Ia oAK \� i ExlsriT►'c GRAVEL GRAVEL BACKFILLEO. PITS// / LOT I _ " / 50 i 16. 135+ S.F. _. /8' OAK V / / o W EXISTINGI t rrTIG TANK E S P ` x ! $ 1 / o NO WATER NO WA TER y l w RA1sE0 3 1 132' 9/.5 /20" 92.5 l h BED G W O I £ r 2 oX 9 'f DATE: JUNE l3. 2011 / © TEST BY: STEPHEN HAAS .gft / WITNESSEDa. , .. BY: Ml GRAND 1 CONCg jE OR/yErN PERC RATE: C 2 M/NIINCH �� � / V � F � Z�r•L CON�R ti /~`�►.�_ ADE FETE / ETE WALK N8 0 VARIANCES REQUIRED : w 160.3,3 ---------� ' I TITLE 5. MAXIMUM FEASIBLE COMPLIANCE SECTION 15.22/:I71 GENERAL CONSTRUCTION REQUIREMENTS FOR ALL SYSTEM COMPONENTS THE TOP OF ALL SYSTEM COMPONENTS SHALL BE NO DEEPER THAN 36" BELOW GRADE. U 7 5.4• MAXIMUM IS PROPOSED. A 2.4' VARIANCE l S REQUESTED. i r - I i SEPT l C SYSTEM LEES l GN l J 37 GLENEAGLE DR J VE " MAP J P J PARCEL 1 44 l � BARNS TABL E ( CENTERV 1 LLE ) MA i PREPARE© FOR : a Q9 LEGEND CHE R YL R O T H WE L L i ■ CB CONCRETE BOUND -W WATER L INE O HYDRANT SCALE 1 2 O ' APR J L 3 2012 --G GAS LINE EAGLE SURVEY I NC I NC OHW- OVER HEAD WIRES � LIGHT POST .� 923 R o u tie 6 A --E-`- UNDERGROUND ELECTRIC LINE Y a r mo u t h p o r t MA . 02675 --- / %► �1,1�\�po T--- UNDERGROUND TELEPHONE L l NE .i' I i \ ( 508 ) 362-8 1 32 -CTV-- UNDERGROUND CABLEVISION LINE �1��� I ( SOB ) 432-5333 +40.4 SPOT ELEVATION __ .--•-40- WSTING CONTOUR REVISED: MAY 4. 20/2 40 PROPOSED CONTOUR LOCUS MAP 0 I D 20 40 JOB N0: i l-064 FIELD:CFW/EEK CAL C: SAH/CFW CHECK: CFW DRN: SAH i